=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063306397
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SARAH RYCROFT, PHD, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/03/2025
-----------------------------------------------------
Last Update Date | 07/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 841 WORCESTER ST STE 115
-----------------------------------------------------
City | NATICK
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01760-2016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-286-6492
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 841 WORCESTER ST STE 115
-----------------------------------------------------
City | NATICK
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01760-2016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-286-6492
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL NEUROPSYCHOLOGIST
-----------------------------------------------------
Name | SARAH SELIGMAN RYCROFT
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 617-286-6492
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103G00000X
-----------------------------------------------------
Taxonomy Name | Clinical Neuropsychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------